[Carcinoma in mature cystic teratoma of the ovary: pathology, therapeutic and prognostic problems].

Carcinoma develops in about 1-2% of ovarian mature cystic teratomas, usually in postmenopausal women, squamous cell carcinoma being the most common tumor type. This study is based on a review of 300 published and 5 new cases. The carcinomatous tissue tends to invade adjacent organs, whereas lymph node metastasis has rarely been diagnosed. A five-year survival rate of about 15% testifies to the poor prognosis. The treatment of tumors confined to the ovary (stage Ia, Ib; FIGO) usually consists of bilateral oophorectomy and total hysterectomy. Exceptionally, in young women of childbearing age, treatment may be limited to unilateral oophorectomy. A thorough surgical, cytologic and bioptic examination of the abdominal cavity should be done to confirm an early tumor stage. In more advanced stages (FIGO Ic to IV), complete eradication of the malignant tissue offers the only chance of cure. The efficacy of chemo- and radiotherapy has not been studied systematically. We suggest that carcinoma in mature cystic teratoma be staged and treated according to the guidelines established for common epithelial neoplasms of the ovary.